Search

Despite recent methodological advances in saturation, guidelines for its estimation in more complex research designs—such as ethnographic studies—have been lacking. We present an accessible, step-by-step approach to empirical assessment of data saturation, tested on a moderately sized ethnographic study with 109 combined direct observations and interviews. The three-phase method includes a priori sample size prediction, provisional saturation estimation during data collection, and post hoc confirmation. Post hoc analysis indicated we reached key thresholds of data saturation before ending fieldwork. We achieved 80% saturation at our 69th data collection event (63% of the full sample) and 90% saturation at our 91st data collection event (83% of the full sample). The method is designed to account for on-the-ground realities confronted in contemporary ethnographic research, including time constraints during fieldwork, and can accommodate studies with medium to large scopes, broad foci, heterogeneous populations, and analysis of multiple qualitative data sources. [ABSTRACT FROM AUTHOR]

The global community is beginning to address non-communicable diseases, but how to increase the accountability of multinational enterprises (MNEs) for the health impacts of their products and practices remains unclear. We examine the Organization for Economic Cooperation and Development's (OECD) efforts to do so through voluntary MNE guidelines. We developed a historical case study of how the OECD Guidelines for Multinational Enterprises were developed and revised from 1973 to 2000 through an analysis of publicly available archived OECD and tobacco industry documents. The first edition of the Guidelines was a purely economic instrument. Outside pressures and a desire to ward off more stringent regulatory efforts resulted in the addition over time of guidelines related to the environment, consumer interests, sustainable development and human rights. Despite their voluntary nature, the Guidelines can play a role in efforts to help balance the interests of MNEs and public health by providing a starting point for efforts to create binding provisions addressing MNEs' contributions to disease burden or disease reduction.

New expansions of health insurance in California are unlikely to attract additional undocumented immigrants to the state, according to a new policy brief from the UCLA Center for Health Policy Research. The brief notes that both legal and undocumented immigrants are primarily motivated to come to the state by employment opportunities and family reunification. This policy brief reviews research studies on undocumented immigration and public benefits, with specific attention to health insurance benefits. Because so few studies examine the migration of undocumented immigrants for health benefits, the authors also review two directly related areas of inquiry: 1) the relationship between public benefits offered by a state and the destination choice of legal immigrants to the United States; and 2) the migration of low-income citizens across state lines in response to public benefits offered by states.

AbstractSubstance use and mental health are highly correlated, though few studies assess the risk for depression and anxiety associated with dual and polysubstance use among college students. The purpose of this study was to characterize the relationship between alcohol, cannabis, and e-cigarette exclusive, dual, and polysubstance use and depression and anxiety among U.S. college students by racial and ethnic subgroup and stratified by sex.Data from 83,467 undergraduate students participating in the 2020–2021 Health Minds Survey, a multi-campus, web-based survey, were used. Sex-stratified logistic regression models examined the effects of exclusive (past 30-day cannabis use, past 30-day e-cigarette use, past 2-week heavy alcohol use), dual (two among cannabis, e-cigarette, or alcohol use), and polysubstance (all three substances) use on anxiety (≥10 GAD-7 score) and depression (≥15 PHQ-9 score).The study included 60,746 females and 22,721 males. Among females, compared to those who exclusively used alcohol, dual users of cannabis and e-cigarette had the largest odds for depression (adjusted odds ratio (aOR) = 1.92) and anxiety (aOR = 1.69) followed by polysubstance users (aORs = 1.85 and 1.53, respectively). Among males, compared to those who exclusively used alcohol, dual users of cannabis and e-cigarette had the largest odds for depression (aOR = 2.72) and anxiety (aOR = 2.23) followed by polysubstance users (aOR = 1.71 and 1.85, respectively). African American female and male students had lower odds of anxiety and depression compared to White students.The results suggest that single, dual, and polysubstance use are associated with anxiety and depression among U.S. college students, though not necessarily in additive ways. [ABSTRACT FROM AUTHOR]

Introduction: Though university smoke-free and tobacco-free campus policies have been proliferating across the US, compliance and enforcement remain challenges. This study examined perceptions and behaviors of employees and students who used tobacco products on tobacco-free campuses, to better understand policy non-compliance., Methods: Students (n=56) and employees (n=20) from two tobacco-free 4-year public universities in Southern California who self-reported using tobacco products on campus participated in focus groups, stratified by university and student or employee (faculty and staff) status, to discuss attitudes toward campus tobacco policies and on-campus smoking. Focus group discussions were transcribed and analyzed after structured coding and subcoding., Results: Participants were generally aware that smoking and vaping were not allowed on campus, though few could correctly identify their campus as tobacco-free. Attitudes toward the policy varied by subgroup and by campus, with students and employees at different universities expressing varying levels of support. Non-compliance was a unique interaction of individual, institutional, and interpersonal factors including a desire to smoke or vape to reduce stress, lack of formal enforcement or penalty for violating the policy, and efforts to smoke or vape in ways that reduce harm to others as a way of rationalizing non-compliance., Conclusions: Attitudes toward university tobacco-free policies are campus- and constituency-specific, with similarities in individual, institutional, and interpersonal factors underlying non-compliance. Interventions to increase compliance should address individual, institutional, and interpersonal influences on non-compliance through efforts tailored to specific campus constituencies based on their particular knowledge and attitudes towards tobacco-free policies., Competing Interests: The authors have each completed and submitted an ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. T. Mackey reports being an employee and co-founder of a company that conducts big data and machine learning research for public health topics, currently funded by the NIH and FDA, outside the submitted work. J. Yang reports funds for attending Tobacco related Disease Research Program, outside the submitted work., (© 2022 Yang J. S. et al.)

Background: The number of colleges and universities with smoke- or tobacco-free campus policies has been increasing. The effects of campus smoking policies on overall sentiment, particularly among young adult populations, are more difficult to assess owing to the changing tobacco and e-cigarette product landscape and differential attitudes toward policy implementation and enforcement., Objective: The goal of the study was to retrospectively assess the campus climate toward tobacco use by comparing tweets from California universities with and those without smoke- or tobacco-free campus policies., Methods: Geolocated Twitter posts from 2015 were collected using the Twitter public application programming interface in combination with cloud computing services on Amazon Web Services. Posts were filtered for tobacco products and behavior-related keywords. A total of 42,877,339 posts were collected from 2015, with 2837 originating from a University of California or California State University system campus, and 758 of these manually verified as being about smoking. Chi-square tests were conducted to determine if there were significant differences in tweet user sentiments between campuses that were smoke- or tobacco-free (all University of California campuses and California State University, Fullerton) compared to those that were not. A separate content analysis of tweets included in chi-square tests was conducted to identify major themes by campus smoking policy status., Results: The percentage of positive sentiment tweets toward tobacco use was higher on campuses without a smoke- or tobacco-free campus policy than on campuses with a smoke- or tobacco-free campus policy (76.7% vs 66.4%, P=.03). Higher positive sentiment on campuses without a smoke- or tobacco-free campus policy may have been driven by general comments about one's own smoking behavior and comments about smoking as a general behavior. Positive sentiment tweets originating from campuses without a smoke- or tobacco-free policy had greater variation in tweet type, which may have also contributed to differences in sentiment among universities., Conclusions: Our study introduces preliminary data suggesting that campus smoke- and tobacco-free policies are associated with a reduction in positive sentiment toward smoking. However, continued expressions and intentions to smoke and reports of one's own smoking among Twitter users suggest a need for more research to better understand the dynamics between implementation of smoke- and tobacco-free policies and resulting tobacco behavioral sentiment., (©Joshua S Yang, Raphael E Cuomo, Vidya Purushothaman, Matthew Nali, Neal Shah, Cortni Bardier, Nick Obradovich, Tim Mackey. Originally published in JMIR Formative Research (https://formative.jmir.org), 24.12.2021.)

Introduction: Concomitant with the popularization of vaping, vape shops have dramatically proliferated over the past years. This study assesses whether vape storefronts in California are significantly associated with density of different age groups, and whether this differs between tobacco storefronts or non-specific tobacco retailers., Methods: Addresses for licensed tobacco retailers were obtained from the California Department of Tax and Fee Administration. Business names and addresses were used to obtain store categories cross-referenced from Yelp. Using a cross-sectional ecological design, stores categorized as 'Vape Shop' or 'Tobacco Shop' were geolocated and compared with age-related variables from the American Community Survey. Regression was conducted in R to determine relationships between age group concentration, in ventiles, and proportion of tracts with tobacco-specific or vape-specific stores. Geospatial visualization was conducted using ArcGIS., Results: We found 848 vape shops, 820 tobacco shops, 419 categorized as both, and 20320 retailers with neither category. Overall, 1800 tobacco and/or vape shops were categorized in 1557 of California's 23194 census tracts. A positive linear association was found between ventiles of two age categories, 20-24 and 25-34 years, and proportion of tracts with vape-specific or tobacco-specific shops separately., Conclusions: Positive associations were found for ages 20-34 years but not for other ages, suggesting vape shops are strategically located in areas populated by young adults. Location-based targeting increases access, thereby increasing proportion of tobacco users, and could be a critical factor in e-cigarette uptake and use. Further study to identify additional age-related demographic characteristics among clientele of tobacco storefronts is warranted., Competing Interests: The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. J. Li and T. Mackey report that they are employees of the healthcare data science startup company S-3 Research LLC, currently funded by an NIH SBIR contract award. V. Purushothaman reports he is an employee of the United Nursing International Health Care Recruiters, with the County of San Diego Health and Human Services Agency. Both companies had no input, provided no funding and had no involvement in this study. All authors report funding from Tobacco-Related Disease Research Program, University of California., (© 2021 Cuomo R. E. et al.)

Expansion of health care coverage has risen to the top of the legislative agenda in California. One question within the health care reform debate is whether expanding health insurance to all Californians will attract new undocumented immigrants who would come primarily for those benefits. A review of studies on immigration and public benefits suggests that the net attraction of any major expansion of health insurance in California would be minor in comparison to the existing attractions of jobs, family and other factors. This policy brief reviews research studies on undocumented immigration and public benefits, with specific attention to health insurance benefits. Because so few studies examine the migration of undocumented immigrants for health benefits, we also review two directly related areas of inquiry: (1) the relationship between public benefits offered by a state and the destination choice of legal immigrants to the United States; and (2) the migration of low-income citizens across state lines in response to public benefits offered by states.